Betty Davis Eyes… (Part II)

Less common:

While only 5-10% will have severe TED, it is important to report these symptoms to your doctor. Keep in mind that not all Opthalmologists (MD or DO specializing in eye treatment) are familiar with TED. Ask your endocrinologist for a recommendation of one who specializes in TED. Early treatment can help to avoid complications like infection that can jeopardize your eyesight.

The initial phase of TED is called the "hot phase" and may last 6-18 months. In this phase, the symptoms may worsen or be at their most severe. Generally, after the hot phase, the symptoms may spontaneously resolve or at least stabilize. Only about 20% may experience continued worsening symptoms and even those may eventually resolve.

Treatment for TED depends on the severity of the symptoms. Eye drops or eye ointments may be used to control dryness. Eyes may be taped closed at night if necessary to prevent damage to the cornea. Using sunglasses will help prevent discomfort from light sensitivity. Elevating the head of the bed or sleeping on two or three pillows may help prevent or decrease swelling in the tissues around the eye.

Surgery may be necessary to correct severe eyelid retraction. However, surgery should only be contemplated once the thyroid levels are back to normal. During the hot phase any surgery or trauma to the eye can make the problem worse.

Taking corticosteroids by mouth can help to decrease the swelling in the soft tissue around the eye and decrease some of the discomfort and disfigurement of bulging eyes. In severe cases, external radiation or orbital decompression (removing some of the bone around the eye to allow more room) may be considered. Up to one-third of those with TED may require surgery, steroids or external radiation to resolve the problem.